Download feeling as if the bowel does not empty properly

Colorectal Service
Patient information folder
Colorectal Team
Surgical Nurse Specialist Department
Incorporating hospital and community health services, teaching and research
Colorectal Nursing and Surgical Team
The colorectal team specialise in all types of bowel problems
including colorectal / bowel cancer. We are available to talk
to you or your family about any worries, problems or issues
you may have at any time throughout your treatment and
follow-up.
The specialist nursing team works together with all the
doctors to plan appropriate treatment for you and ensure that
you are fully aware of what is happening at every stage of
your treatment. Our aim is to provide continuity for you
throughout your treatment and the many departments you
will visit in the course of the next few months.
This booklet is designed so you can collect information on
your treatment in a systematic way. However please feel
welcome to contact us if you require any other information.
Who we are
Nursing Team
Luisa Price, Nurse Specialist
020 8510 7852
Angela Davy, Stoma Nurse Specialist 020 8510 5318
Stella Reuben-Jack Stoma Care Support Nurse
Nurse Specialist (Keyworker) is available
Monday – Friday, between 9am – 5pm
If no one is available a message can be left on your
Keyworker’s mobile phone and they will contact you on their
return.
Surgical Team
There are three colorectal surgeons at the Homerton, all of
whom specialize in surgery to the large bowel and rectum,
including surgery for bowel cancer.
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Consultant Colorectal Surgeons
Miss Helen Pardoe
Mr Sanjay Wijeyekoon
Surgical Secretaries:
Sandra Kelly (Secretary to Mr Wijeyekoon) – 020 8510 7981
Valerie Nelson (secretary to Miss Pardoe, Luisa Price,
Angela Davy) –
020 8510 7953
Key Worker
Your key worker will provide practical and emotional support
to you and your family. The key worker is the person who,
with your agreement, takes a key role in co-ordinating your
care, promoting continuity of care and ensuring that you
know who to access for information and advice.
Your key worker is:
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This information was produced by the Colorectal Nursing and
Surgical Team at Homerton University Hospital in
conjunction with the patients’ support group.
Your doctor has explained to you that you may have a bowel
cancer, which needs investigation, or that you have definitely
been diagnosed with a bowel cancer. This booklet can be
used to keep a record of the treatment you have received or
may receive and the people you will see. This folder will give
you information regarding bowel cancer, the tests and
investigations you have had or may need and information on
the care and treatment that you can expect. If, however, you
would like more information please do not hesitate to ask.
Bring the folder with you each time you attend hospital and
we can add to it and write notes in it as appropriate.
Your team
Consultant surgeon leading your care:
……………………………………………………………………………
Other doctors involved in your care:
………………………………………………………………
………………………………………………………………
………………………………………………………………
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Diagnosis
Your diagnosis of bowel cancer (colorectal cancer) will have
been made from the results of tests and investigations that
you have had.
You may have had some of these tests / investigations

Rigid sigmoidoscopy and / or proctoscopy

Flexible sigmoidoscopy

Colonoscopy

Biopsies

X-rays

Barium enema

Scans – CT scan, MRI, PET

Blood tests.
In some circumstances the diagnosis of bowel cancer cannot
be confirmed until the suspected cancer is removed at
surgery and analysed by the histopathologist (specialist
consultant who examines tissue and cells under a
microscope). The results of these tests can take up to 14
days after your operation.
Once a diagnosis of bowel cancer has been made your
doctor will discuss your case with other members of the
colorectal multi-disciplinary team (MDT). A weekly MDT
meeting is held every Friday at 8.30am and your results will
be discussed at this meeting and your treatment
planned/formulated. This is so the best possible treatment
can be planned with experts from different specialities such
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as the oncologist, radiologist, histologist, Macmillan doctors,
surgeons and specialist nurses.
Results:
Diagram of the bowel
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Bowel cancer
Cancer of the large bowel, also known as colorectal cancer,
is the third most common cancer in the UK. Bowel cancer
can affect the large bowel (colon) or the rectum (back
passage). There are around 36,000 cases every year in the
UK, yet, it is one of the most curable forms of cancer if found
and treated in the early stages. When the disease is caught
early, the cure rate after surgery can be around 90%. Even if
the disease cannot be totally cured, patients can still have a
good quality of life, and other treatments are often available.
The large bowel (colon and rectum)
The bowel is part of the digestive system and is made up of
two parts, the small bowel (small intestine or ileum) and the
large bowel (large intestine). The large bowel consists of the
large bowel (colon) and the rectum and together they form a
long, muscular tube approximately 1.5m in length.
Once food has been swallowed, it passes down the
oesophagus (gullet) into the stomach and digestion begins.
The food then passes into the small bowel where digestion
continues and the body absorbs the nutrients. The digested
food continues to the large bowel where water is absorbed
and the waste matter or stool gradually forms. The stool is
stored in the rectum / back passage, until it is ready to be
passed out of the body as a bowel motion.
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What is cancer?
The body is made up of cells, which grouped together form
the tissues and organs of the body, for instance the brain,
lungs and bowel. Cancer is a disease of the cells.
Cells normally reproduce by dividing in a regular orderly way
so growth and repair of the body tissues can occur.
However, sometimes this process gets out of control and
results in a lump developing within that group of cells. This is
called a tumour.
Tumours can be benign (non-cancerous) or malignant
(cancerous). A malignant tumour (cancer) has the ability to
spread. Sometimes cells break away from the original
(primary) cancer and spread to other organs in the body
through the blood stream or lymphatic system. The lymphatic
system is part of the body’s defence against infection and
disease. The system is made up of a network of lymph
glands/nodes that are linked by fine ducts containing lymph
fluid. When the cancer cells reach a new site, they may go
on dividing and form a new tumour, often referred to as a
secondary or a metastasis.
What is bowel cancer?
Cancer can be used to describe many different diseases.
Polyps can be one of the causes of developing colorectal
cancer. These form in the lining of the bowel and if left
untreated can develop into cancer over a long period of time
(sometimes several years). However, the cause of these
polyps is unclear. There is no evidence of the original polyps
by the time bowel cancer is diagnosed. Most bowel cancer is
situated within the bowel wall. An operation is needed to
remove these cancers.
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Colorectal cancer is not a disease that can be caught from
other people, but one that develops within the body.
The causes of bowel cancer
The cause of bowel cancer is not fully known. However, it is
more common in western societies and there is some
evidence that it is linked to a western diet. This diet is high in
animal protein and fat and low in fibre (fresh fruit and
vegetables) and is thought to increase the risk of developing
cancer.
Another risk factor is age. More than 8 out of 10 bowel
cancers are diagnosed in people who are over 60 so the risk
of developing a bowel cancer increases as you get older.
Having a strong family history of bowel cancer may also
increase the risk of developing the disease. However this is
when bowel cancer has been diagnosed in a close family
member (e.g. parent, sister or brother) under the age of 45
years.
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Similar to other cancers there have been links made between
bowel cancer and smoking.
Symptoms
The symptoms of colorectal cancer are often very minor or
not apparent at all. The symptoms may include:









change in bowel habit – either diarrhoea or
constipation
blood and / or mucus in your stool
stools that are smaller and /or narrower than usual
pain in the stomach or back passage – cramps or
tenderness
bloated sensation
frequency and sometimes painful wind
feeling as if the bowel does not empty properly
unexplained anaemia
unexplained weight loss.
Because bowel cancer can bleed on and off, it can
commonly cause anaemia. This is a shortage of red blood
cells in the body, leading to tiredness and sometimes
breathlessness.
Sometimes cancer of the bowel can cause a blockage. Your
doctor may call this a bowel obstruction. The symptoms of
this are:
 griping pains in the abdomen
 feeling bloated
 constipation
 being sick
It is important to remember that other diseases can also
cause these symptoms apart from bowel cancer. Sometimes
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people with bowel cancer do not have any of these
symptoms.
Investigations
In diagnosing bowel cancer a number of different
examinations and tests may be carried out, the initial ones
were probably carried out when you were seen by a doctor or
nurse in the outpatients’ clinic.
Rectal examination - PR
It is a simple procedure. The doctor/nurse gently puts
lubricated gloved finger into your rectum and feels for any
lumps or swellings. The examination may be slightly
uncomfortable, but should not be painful.
Sigmoidoscopy and proctoscopy
The doctor/nurse uses these tests to look inside the anus
(proctoscopy) or rectum and lower part of the large bowel
(sigmoidoscopy). While you lie on your side, the doctor/nurse
puts a thin tube into your back passage and inflates your
bowel with some air. Blowing air into the bowel helps the
doctor to see inside more clearly. The tube also has a small
light inside it, which again helps the doctor to see into your
bowel. The doctor may take a biopsy (small sample of tissue)
if necessary. This will be looked at under a microscope by a
specialist to see if it contains any cancer cells.
These tests can be done as an outpatient and you will be
able to go home after the test is over. The tests, although
uncomfortable, are not normally painful and you do not need
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an anaesthetic. You may notice a small amount of blood in
your stool; this is quite normal and will stop after a few days.
Blood tests
In outpatients you may have a variety of blood tests. Some
will be used to exclude other diseases, such as an under
active thyroid or any inflammatory bowel disease. The
doctor requesting these will explain what your particular tests
are for.
Barium enema
This is an X-ray of the large bowel. For this test you have to
have an empty bowel. You will be




given laxatives to take the day before
asked to drink lots of fluids the day before
asked not to eat solid food the day before the test
asked not to eat and drink anything on the morning of
the test.
Barium is a white liquid which shows up on X-rays. A mixture
of barium and water is passed into the rectum. You will be
asked to try to hold the liquid in the rectum until all the X-rays
have been taken. The barium passes through the bowel and
shows up any lumps or strictures (tightening of the bowel).
The doctor can watch on an X-ray screen.
The test can be uncomfortable and tiring. It is best to have
someone to take you home afterwards. After the test you
may feel constipated and your first couple of stools will
appear white. Your stools will return to normal colour after
the barium is out of your system.
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Colonoscopy
A colonoscopy is a test that allows the doctor to look directly
at the lining of the large bowel (colon). In order to do the
test, a colonoscope is carefully passed through the anus into
the large bowel.
The doctor is able to look down the
colonoscope and get a clear view of the lining of the bowel.
The doctor may take a biopsy, a sample of the lining, for
examination in the laboratory. A small piece of tissue is
removed painlessly through the colonoscope, using tiny
forceps.
Diagram of the colonoscopy procedure
For this test the bowel has to be empty so the doctor can get
a clear view. You will be given a list of things to do to help
prepare the bowel for the test. The hospital will give you
detailed instructions about cleaning the colon. It is important
to take all the laxatives prescribed and increase your intake
of clear fluids.
You will be given a sedative and painkiller just before the test
to help you relax. This is given via a small needle placed into
a vein, usually in the back of the hand or lower arm. You will
be asked to lie on your side. The doctor will pass a flexible
tube into your anus and up into your bowel and air will be
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passed through it to distend the colon to give a clearer view
of the lining. As the tube bends easily, it can pass around
the curves in the bowel so your doctor can examine the
whole length of it. The light inside the tube helps the doctor
to see any problem areas or swelling.
A colonoscopy can be uncomfortable but the sedative and
painkiller should help you to feel more relaxed.
You should be able to go home a couple of hours after the
test. As you have had a sedative, you should have someone
with you to take you home. You shouldn’t drive for four –six
hours after the sedation. You may eat and drink normally
immediately after the test. As this procedure does carry a
very small risk of complication, you will be asked to sign a
consent form indicating that you understand why the
procedure is being performed and what the risks are.
Examination under anaesthetic (EUA)
If a rectal cancer is suspected the medical team may decide
to look at the area more closely whilst you are asleep. This
test is usually carried out as a day procedure and requires a
full anaesthetic. Prior to the test you will be given an enema
to clear out the rectum.
CT scan
"CT" or "CAT" scan is the term used to describe a
radiological test known as "computerized tomography." The
CT scanner is a doughnut-shaped machine that takes
pictures of cross-sections of your body, called "slices." CT
can see inside the brain and other parts of the body, into
areas that cannot be seen on regular x-ray examinations. CT
makes it possible to diagnose certain diseases more
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accurately than with other imaging devices, as it shows
images of the soft tissues.
When you receive the appointment for the CT scan you will
be asked not to eat or drink anything for four hours before
the scan, although you should take any prescribed
medication as usual. You will be asked to arrive one hour
before the scan so that you can be given a special drink
called gastrografin (contrast material) which outlines the
organs being looked at on the scan. You will be asked to
drink this slowly over the one hour period before the scan.
The radiographer will bring you into the CT scan room where
you will lie down on the patient couch (usually on your back).
You should get comfortable because it is very important that
you do not move during the test. In order to see your organs
and blood vessels clearly, you will be given an injection of a
contrast agent (a colourless liquid) into your arm by the
radiologist. Although the radiographer cannot stay in the
scan room with you, you can speak to him/her at any time via
an intercom. Your scan should take between five to ten
minutes.
CT scanner
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MRI scan
A "MRI" scan is the term used to describe a radiological test
known as "Magnetic Resonance Imaging." MRI scanning
combines a powerful magnet with a sophisticated computer
to produce a picture of your internal organs without the need
for x-rays. Extensive evaluation has shown no known side
effects as there is no use of radiation, therefore making it low
risk. There is no special preparation required before this test.
You can eat and drink as normal and continue on any usual
medication.
MRI scanner
Because there is a strong magnetic field, this could cause
problems for patients with metallic implants. Due to this, you
cannot have an MRI scan if you have a cardiac pacemaker,
cochlear implant, aneurysm clip in the brain, neuro
stimulators and metallic objects in the eye. You may also be
excluded from having this scan if you are pregnant. The
magnetic field can also damage certain items; do not take
watches, hearing aids, electronic pagers or credit cards into
the scanner.
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When you come for the scan try to wear clothing with no
metal parts such as zips or hooks, otherwise you will need to
change into a hospital gown. You will be asked to remove
any dentures, jewellery, hearing aids, hairpins and make-up.
Please leave all valuables at home as the hospital is not
responsible for your property. You will lie on a couch which
is moved into the magnet. The scanner is quite noisy so you
will be given headphones to wear during the procedure. The
procedure lasts for 30 to 60 minutes and the radiographer
will be able to see and hear you at all times.
Both the CT and MRI scan are usually used once a diagnosis
of bowel cancer has been made. They help to give the
medical team more information about your cancer and to find
out whether the cancer has spread to other organs such as
your liver or lungs. This information will then be used to
assist the medical team in making decisions about your
treatment.
Ultrasound scan
An ultrasound scan is performed in the x-ray department and
is an outpatient procedure. The test takes about 10 – 15
minutes and you can go straight home afterwards. The scan
involves passing a beam of sound via a small hand held
device, like a microphone, over the abdomen. A clear jelly
which may field cold is used to lubricate the abdomen and
provide good images. This scan is performed regularly on
pregnant women to gain a picture of the developing baby.
This is a quick and risk-free way of looking at the internal
organs, such as the liver and kidneys. Tissues of varying
thickness reflect sound waves differently and these can be
converted into a ‘map’ by a computer. This ‘map’ is shown
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on the computer screen on which the internal organs and any
abnormalities within them can often be seen.
The procedure is completely painless and the only
preparation usually required is to have a full bladder.
PET scan
PET stands for Positron Emission Tomography. This is a
fairly new type of scan developed in the 1970s. It can show
how body tissues are working, as well as what they look like.
PET scanners are very expensive and only a few hospitals in
the UK have one. This means that you will have to travel to
another hospital for your scan (usually for Homerton patients
these scans are carried out at St. Bartholomew’s Hospital).
Not everybody who has bowel cancer will need to have a
PET scan. Normally PET scans are used if there is
uncertainty surrounding a diagnosis e.g. if a CT scan is
showing a lump in the liver but cannot confirm if it is cancer.
If you require a PET scan, you will receive an appointment
from the hospital that is carrying out the scan. They will send
you details about what to do to prepare for the scan. Unless
you are told otherwise, always take any prescribed
medications as usual.
With a PET scan you first have an injection of a very small
amount of a radioactive drug (tracer). The amount of
radiation is very small (no more than you have during a
normal x-ray) and it only stays in the body for a few hours.
Depending on which drug you have, the radioactive drug will
travel to particular parts of your body. The most common
drug is fluorine 18 also known as FDG-18. This is a
radioactive version of glucose. When FDG-18 is injected into
your body it travels to places where glucose is used for
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energy. It shows up cancers because they use glucose in a
different way from normal tissue.
After you have the injection you rest for about an hour to
allow the radioactive tracer to spread through the body. The
scan itself can take up to an hour and produces an image of
the radioactive tracer in the body. It is important that you lie
as still as possible while the scan is being done. The scan
should not be painful or uncomfortable. If you begin to feel
unwell or want some help, you will have a buzzer that you
can press to get attention.
There are no side effects of this type of scan and after the
scan you should feel fine and be able to resume your normal
diet and activities.
After the tests
You will be asked to come back to the hospital when your
test results have come through, this usually takes
approximately two weeks. At this appointment your test
results will be explained and a treatment plan discussed.
This is where you will decide whether you want to have
treatment.
Waiting for the test results is bound to be a very anxious time
for you. While you are waiting, it may help to talk to a close
friend or relative about how you are feeling.
You are free to contact the specialist nurses at any time if
you have any concerns and questions and there are details
at the back of this information folder about support groups
that you can also access.
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What treatments are available for bowel
cancer?
Treatment for bowel cancer can vary depending on the
location of the tumour. If you have a cancer in the large
bowel the main form of treatment is surgery to remove the
cancer. Once the cancer has been removed it is analysed at
the laboratory and the specimen is staged (see below).
Depending on the results of these tests your doctor, together
with the multidisciplinary team may decide that you need
further treatment in the form of chemotherapy.
If you have been diagnosed with a cancer in the rectum, a
combination of radiotherapy (x-ray treatment) and
chemotherapy may be used to shrink the tumour, prior to
surgery being carried out to remove the cancer. As
mentioned above, once surgery has been completed, further
treatment may be required in the form of chemotherapy.
In some instances (e.g. if the cancer has spread to other
parts of the body) surgery is not the best option, and other
treatments such as radiotherapy or chemotherapy are used
instead.
Radiotherapy
Radiotherapy is the use of x-rays or other high-energy rays
to kill cancer cells and shrink tumours. The treatment is
individually planned and monitored for each patient and is
given as a series of short, daily treatments in the
radiotherapy department at St. Bartholomew’s Hospital. The
equipment used is similar to a large x-ray machine.
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The treatments are usually given from Monday to Friday,
leaving patients to rest at the weekend. Each treatment is
called a fraction. Giving the treatment in fractions ensures
that minimal damage is done to normal cells and the damage
to normal cells is mainly temporary.
Radiation treatment
For most curative (radical) treatments, planning is a very
important part of radiotherapy and may take a few visits.
Careful planning makes sure that the radiotherapy is as
effective as possible. It ensures the radiotherapy rays are
aimed precisely at the cancer and cause the least possible
damage to the surrounding healthy tissues. The treatment is
planned by a cancer specialist (clinical oncologist) and a
physicist. You may have your first treatment on the same day
as your planning session, but often it is necessary to wait a
few days while the physicist and specialist prepare the final
details of your treatment.
Chemotherapy
Chemotherapy is a drug treatment. It is the use of cytotoxic
drugs that destroys cancer cells by interfering with their
ability to divide and grow. It can be used in combination with
radiotherapy prior to surgery for rectal cancer or after surgery
for bowel cancer (depending on the stage of the cancer). The
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drugs can be given by mouth or an injection into the vein or
through a central venous catheter (line in the side of your
neck).
If you are advised and referred to have chemotherapy or
radiotherapy
extra
information
covering
these
treatments will be given to you.
Combination treatment
As mentioned earlier, a combination treatment of
chemotherapy and radiotherapy is often used to treat rectal
cancer to shrink the tumour before it is removed during
surgery. Your exact treatment plan will depend on what your
doctor thinks is best for you.
All aspects of adjuvant therapy will be discussed in
detail with you as soon as we have confirmation that you
may benefit from it.
Colorectal surgery
The main treatment of bowel cancer is surgery. The aim of
surgery is to remove the affected bowel. The doctor will also
take out lymph nodes near the intestine and everything
removed will be examined under the microscope to
determine whether there is a cancer and if it has spread
outside the bowel. The removal of the bowel is called a
resection and may have one of two outcomes:
I.
The bowel is reconnected by a join called an
anastomosis which re-establishes the continuity of the
bowel.
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II.
If the doctor is unable to sew the colon back together,
he/she will make an opening (stoma) on the abdomen
to collect waste. There are different types of stoma
depending on where the tumour is situated. They can
either be a colostomy or ileostomy.
Sometimes, the stoma is temporary and only needed
until the colon has healed, and then it can be
reversed. However, if the entire lower colon needs to
be removed then the stoma is permanent. If this
happens you will be given a lot of support within the
hospital and at home.
The type of operation will depend on your individual
circumstances i.e. the position and size of your tumour. Your
surgeon and specialist nurse will discuss this with you and
give you written details of the agreed operation.
Staging
The stage of a cancer tells the doctor whether it has spread
to other parts of the body. This is important because it helps
doctors to advise on the best treatment options. For
colorectal cancer, it may not be possible to give an accurate
staging until after an operation to remove the tumour.
Dukes’ staging
Colorectal cancer is often staged according to the Dukes
system. You may hear your specialist talking about your
colorectal cancer as a Dukes’ A, B, C or D. This is what the
classification means

'Dukes A' means the cancer is only affecting the inner
lining of the colon or rectum
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


'Dukes B' means the cancer has grown into the
muscle layer in the wall of the colon or rectum
'Dukes C' means the cancer has spread to at least
one lymph node in the area of the colon or rectum
'Dukes D' means the cancer has spread to other parts
of the body. The most common site of colorectal
cancer to spread is the liver or lung.
Are there any alternatives to surgery?
Surgery is the only treatment to remove your tumour.
However, you can discuss the different options available with
your doctors and nurses.
Referrals
Who to?
Date
Name and telephone
contact
District Nurse
Macmillan Nurse
Palliative Care
Dietician
Social Services
Oncology
Oncology Nurse
Counsellor
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Other
Investigation and results
Date
Investigation
Result
Patient diary
This section is for you to fill in. You may want to keep a
record of your treatment and how you felt about it,
highlighting the good and bad points. This can be just for
you or you can feed back to the nurse specialist. We are
continually trying to improve the service we provide, let us
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know areas in which you feel we can improve the service for
others.
Date
Experience
Date
Experience
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Date
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Experience
Questions
When you see the doctor or nurse you may forget to ask
about something that is worrying you or you may remember
something you wanted to ask after the appointment. This
section is for you to document questions you wish to ask.
Please make a record of any question you would like to ask
the doctor or nurse.
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Medical words and terms
These are some of the medical words and terms you may
come across during your investigation and treatment.
Abdomen
Abscess
Acute
Adjuvant therapy
Anaemia
Analgesia
Anastomosis
Anus
Barium Enema
Benign
Biopsy
Caecum
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Tummy or belly
A localised collection of pus in a
cavity formed by the decay of
diseased tissue
Sudden onset of symptoms
Chemotherapy and radiotherapy in
addition to surgery
A reduction in the number of red
cells, haemoglobin (iron) or volume
of packed red cells in the body
Pain killers such as paracetamol
and morphine
The joining together of two ends of
healthy bowel after diseased bowel
has been cut out (resected) by the
surgeon
The opening to the back passage
A diagnostic x-ray of the large
bowel (colon). Barium is inserted
into the rectum via the anus (back
passage) and rolled around the
bowel.
Non cancerous
Removal of small pieces of tissue
from parts of the body (e.g. colon –
colonic biopsy) for examination
under
the
microscope
for
diagnosis.
The first part of the large intestine
forming a dilated pouch into which
the ileum, the colon and the
appendix opens.
Chronic
Symptoms occurring over a long
period of time
Chemotherapy
Drug therapy used to attack cancer
cells
CNS
(Clinical A qualified nurse that has
Nurse specialist)
specialised in a particular field of
care.
Colitis
Inflammation of the colon
Colon
The
large
intestine
(bowel)
extending from the caecum to
rectum
Colonoscopy
Inspection of the colon by an
illuminated telescope called a
colonoscope.
Colorectal
Surgeon who specialises in the
Surgeon
treatment of conditions in the large
bowel and rectum including bowel
cancer.
Colostomy
Surgical creation of an opening
between the colon and the surface
of the body. Part of the colon is
brought out of the abdomen
creating a stoma. A bag is placed
over this to collect waste material.
Constipation
Infrequent or difficulty in the
passage of bowel motion stool
(faeces).
CT scan (CAT (computerised axial tomography) A
scan)
type of x-ray. A number of pictures
are taken of the abdomen and fed
into a computer to form a detailed
picture of the inside of the body.
Defaecation
The act of passing faeces (having
your bowels opened)
Diagnosis
Finding out what is wrong with you
Diarrhoea
An increase in frequency and
liquidity of bowel motions
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Distal
Diverticulum
Dysplasia
Electrolytes
Enema
Endoscopy
Exacerbation
Faeces
Fistula
Heredity
Ileostomy
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Further down the bowel towards
the anus.
Small
pouch-like
projections
through the muscular wall of the
intestine which may become
infected, causing diverticulitis.
Alteration in size, shape and
organisation of mature cells that
indicate possible development of
cancer.
Salts in the blood e.g. Sodium,
potassium and calcium
A liquid introduced into the rectum
to encourage the passing of
motions
A collective name for all visual
inspections of body cavities with an
illuminated
telescope.
E.g.
colonoscopy,
sigmoidoscopy,
gastroscopy.
An aggravation of symptoms
The waste matter eliminated from
the anus (other names – stools,
motions).
An abnormal connection, usually
between two organs, or leading
from an internal organ to the body
surface (e.g. between the anus and
skin surface – anal fistula)
The transmission of characteristics
from parent to child
This is when the open end of the
healthy ileum (small bowel) is
diverted to the surface of the
abdomen and secured there to
form a new exit for waste matter
(faeces).
Incontinence
Inflammation
Inoperable
Laxative
Lesion
Malignant
Mucus
Neutropenia
Oedema
Oncologist
Palliative care
Pathology
Perforation
This is when you are unable to
hold on to or control your waste
products, e.g. stool or urine.
A natural defence mechanism in
which blood rushes to any site of
damage or infection in the body
leading to reddening, swelling and
pain. The area is usually hot to
touch.
A growth or tumour that cannot be
surgically removed
Medicine or tablet that acts to
cause emptying of the bowel. This
may be by purging (irritating the
lining) or increasing the volume of
stool (bulking)
A term used to describe any
structural abnormality in the body
Cancer
A white, slimy lubricant produced
by the large bowel
Reduction in the number of white
cells which fight infection
Accumulation
(build-up)
of
excessive amounts of fluid in the
tissues resulting in swelling.
A doctor who specialises in cancer
care using drugs and radiotherapy
Improving the quality of life by
providing support and the control of
pain and unpleasant symptoms.
The study of the cause of the
disease
An abnormal opening (hole) in the
bowel wall which causes the
contents to spill into the normally
sterile abdominal cavity.
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Peritoneum
Peritonitis
Polyp
Prophylaxis
Proximal
Radiotherapy
Rectum
Relapse
Remission
Sigmoid
Sigmoidoscopy
Stricture
Suppository
Tenesmus
Terminal ileum
Tumour
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The
membrane
lining
the
abdominal cavity
Inflammation of the peritoneum,
often due to a perforation
A protruding growth from the
mucous membrane (lining of the
bowel) e.g. colonic polyp – in the
colon
Treatment to prevent a disease
occurring.
Further up the bowel towards the
mouth
The use of high energy rays which
attack cancer cells
The large intestine, above the anus
(the back passage)
Return of disease activity
A reduction in symptoms caused
by the disease and return to good
health
The portion of the colon shaped
like a letter ‘S’ or ‘C’ extending
from the descending colon to the
rectum
Inspection of the sigmoid colon
with an illuminated telescope called
a sigmoidoscope
The narrowing of a portion of the
bowel
A bullet-shaped solid medication
put into the rectum
Persistent urge to empty the bowel
The last part of the ileum joining
the caecum via the ileo-caecal
value
An abnormal growth which may be
benign
(non-cancerous)
or
Ulcerative colitis
Ultrasound
malignant (cancer)
Ulceration and inflammation of the
large bowel
Use of high-pitched sound waves
to produce pictures of organs on a
screen for diagnostic purposes
Useful contacts
Beating Bowel Cancer
Harlequin House, 7 High Street, Teddington,
TW11 8EE
General Helpline: 08450 719 301
Nurse Advisory Service: 08450 719 301 (9.00am – 5.30pm)
Email: [email protected]
Website: www.beatingbowelcancer.org
Provides expert knowledge support, raising awareness and
information about bowel cancer so that individuals can make their
own informed decisions of their treatment.
Bowel Cancer UK
4 Rickett Street, London SW6 1RU
Tel: 020 7381 9711
Advisory line: 0800 840 35 40 (10.00am – 4.00pm)
Email: [email protected]
Web page: www.bowelcanceruk.org.uk
Advisory line staffed by specialist nurses providing advice and
information service for all those affected or concerned about the
disease.
Bowel cancer information in other languages available.
Cancer Research UK
Cancer Research UK, P.O. Box 123, Lincoln's Inn Fields, London
WC2A 3PX
Cancer information nurses: 0808 800 4040, 9am - 5pm
Email: [email protected]
Website: www.cancerresearchuk.org/cancer-help/
33
Cancer Research UK is dedicated to cancer research, provides
information on site specific cancers and influences public policies.
The Website provides information for bowel cancer patients.
Hackney Citizens Advice Bureau
Local Office: 300 Mare Street, London E8 1HE
Tel: 020 8525 6350
Website: www.eastendcab.org.uk/
Mare Street office offers drop-in clinics Monday-Thursday from
8.30am. Friday doors open at 9.30am.
Advice line operates Tuesday and Wednesday from 1pm – 3pm
and 10am-12pm (for clients with mobility problems). Tel: 0844 499
1195.
The Citizens Advice service helps people resolve their legal,
money and other problems by providing free information and
advice from over 3,000 locations, and by influencing policymakers.
Colostomy Association
2 London Court, East Street, Reading, RG1 4QL
Tel: 0118 939 1537
Helpline: 0800 328 4257 (24 hour)
Email: [email protected]
Website: www.colostomyassociation.org.uk
Provides support and advice for colostomates, their families and
their carers. Free literature and information is available about all
aspects of living with a colostomy.
Core – Fighting Gut and Liver Disease
3 St Andrews Place, London, NW1 4LB
Telephone: 020 7486 0341
Email: [email protected]
Web page: www.corecharity.org.uk
Fund research in order to prevent, cure or treat digestive disorders
and provide information for sufferers, their families and friends.
Ileostomy and Internal pouch support group
Peverill House,1 – 5 Mill Road, Ballyclare, Co. Antrim, BT39 9DR.
Tel: 0800 0184 724 (Office hours)
34
Email: [email protected]
Website: www.iasupport.org/uni_contact.aspx
Aims to help anyone who has had or is about to have their colon
removed and has an ileostomy or internal pouch. Provides advice,
information and leaflets.
Institute for Complementary Medicine (ICM)
32-36 Loman Street, London SE1 0EH
Tel: 0207 922 7980
Email: [email protected].
Fax: 0207 922 7981
Website: icnm.org.uk/
Provides the public with information on Complementary Medicine
Macmillan Cancer Support
89 Albert Embankment, London SE1 7UQ
Macmillan cancer line: 0808 808 0000 (9am – 8pm)
Website: www.macmillan.org.uk
Provides specialist advice and support for cancer patients and
financial advice and grants for people with cancer and their
families.
NHS Direct
Telephone: 111
www.nhsdirect.nhs.uk
The Polyposis Registry
St. Mark’s Hospital, Northwick Park Hospital, Watford Road,
Harrow, HA1 3UJ
Tel: 020 8235 4270
Email: [email protected]
Website: www.polyposisregistry.org.uk
Provides support and information to people who have, or may
have, the familial adenomatous polyposis (FAP) gene, and so are
at greater risk of developing bowel cancer.
Other sources of information
Royal College of Anaesthetists - www.rcoa.ac.uk “You and your
Anaesthetic”
35
The Royal College of Surgeons - www.rcseng.ac.uk
Important information
Please remember that this leaflet is intended as general
information only. It is not definitive. We aim to make the
information as up to date and accurate as possible, but please be
warned that it is always subject to change. Please, therefore,
always check specific advice on the procedure or any concerns
you may have with your doctor.
Hand hygiene
In the interests of our patients the Trust is committed to
maintaining a clean, safe environment. Hand hygiene is a very
important factor in controlling infection. Alcohol gel is widely
available throughout our hospitals at the patient bedside for staff to
use and also at the entrance of each clinical area for visitors to
clean their hands before and after entering.
Other formats
If you require this leaflet in any other format such as larger print,
audio tape, Braille or another language please speak to your
clinical nurse specialist (Keyworker).
Reference
The following team members have been consulted and agreed this
patient information:
Consultant, Clinical Nurse Specialist (Keyworker), Macmillan
Cancer Information and Support Manager and Patient.
Homerton Hospital Health and Cancer Information Centre
Based at the front of the hospital
Tel: 020 8510 5191 (Mon – Friday 9am – 5pm)
Email: [email protected]
Homerton Health Shop is a drop-in Health and Cancer Information
Centre, based at the main entrance of the Trust. Macmillan Cancer
Information and Support Manager provides cancer information,
financial, practical and emotional support to anyone affected by
cancer, their relatives, carers and friends.
36
Patient Advice and Liaison Service (PALS)
PALS provide information and support to patients and carers and
will listen to your concerns, suggestions or queries. The service is
available between 9 am and 5 pm. Telephone 0208 510 7315
Email: [email protected]
Produced by: Cancer Services
Homerton University Hospital NHS Foundation Trust
Homerton Row, London, E9 6SR
T 020 8510 5555
W: www.homerton.nhs.uk
E: [email protected]
Reviewed: March 2014
Next review date: March 2016
37